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Ketones In Urine Child

Ketones And Children With Type 1 Diabetes – What’s Important?

Ketones And Children With Type 1 Diabetes – What’s Important?

What are ketones and when do you check for them in children with type one diabetes? This is a common question I get! I think when children are diagnosed, this a frequent part of the education that is easily forgotten or misunderstood due to the overwhelming amount of information being taught. So let’s look at why we would check ketones, how to check them, what the colors on the strips mean, and what to do if ketones are present. Why Check Ketones: When someone with type 1 diabetes does not not get enough insulin, their blood sugar levels rise, so the body is forced to use fat for energy. When fat is used for energy for an extended period of time, ketones develop. Ketones are a waste product of fat. If someone with type 1 diabetes does not get enough insulin, diabetic ketoacidosis (DKA) can develop. The length of time it takes and how high one’s blood sugar are varies, however DKA can occur in a few hours. Symptoms of DKA: high blood sugars ketones in blood and urine nausea, vomiting, and abdominal pain confusion lethargy (tired, sluggish, weak) difficulty breathing unconsciousness DKA is a very serious and life threatening situation. Speak with your health care providers to determine how you are to treat ketones and when you are to go to the emergency room. When to check ketones: Your doctor can tell you exactly, but usually when your blood sugars are over 250, especially if the blood sugar is not responding to insulin and remaining high after the second blood sugar check. Always check ketones when your child is sick, even if blood sugar numbers are not high. Anytime your child has nausea and vomiting, check ketones. How to check ketones: Ketones can be checked by using ketone urine strips. To check ketones, urinate on a strip, or collect urine and dip stick into ur Continue reading >>

Ketone Testing: About Your Child's Test

Ketone Testing: About Your Child's Test

What is it? A ketone test checks for ketones in your child's blood or urine. Ketones are made when the body breaks down fat for energy instead of using sugar. This can happen when children with diabetes are ill or don't get enough insulin. Newer home blood sugar meters can measure ketone levels in the blood. You can also use home urine tests to measure ketones. Why is this test done? Measuring your child's ketones is recommended whenever your child has symptoms of illness, such as nausea, vomiting, or belly pain. These symptoms are similar to symptoms of high blood sugar and may mean that your child has diabetic ketoacidosis. This condition is very serious and needs immediate treatment. How can you prepare for the test? In general, your child doesn't need to prepare before having this test. Your doctor may give you some specific instructions. What happens during the test? Blood test in a doctor's office or hospital: A health professional takes a sample of your child's blood. Blood test at home: Some home blood sugar meters can also measure blood ketones. You use the same finger-prick method that you use to measure your child's blood sugar. Home urine test: Collect a sample of urine in a clean container. Follow the manufacturer's directions on the bottle of test strips or tablets. What else should you know about the test? With the home urine test, if either the test strip changes colour or the urine changes colour when the tablet is dropped into the sample, ketones are present in your child's urine sample. The test results are read as negative to 1+ to 4+, or small to large. Blood ketone tests using a meter display the result on the monitor. Your doctor can tell you what ketone range is high for your child (for example 0.6 mmol/L or higher). Your doctor may recommend tha Continue reading >>

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Having a sick child can be challenging—getting time off work and securing a last-minute doctor's appointment isn't always easy. But when your sick child also happens to have type 1 diabetes, it presents a separate set of complications relating to insulin and blood glucose (blood sugar) management. This article covers some important considerations to keep in mind the next time your child with type 1 diabetes feels under the weather. Checking Blood Glucose and Ketones Even the most common ailments, such as a cold or flu, can cause your child's blood glucose levels to rise. Plus, some over-the-counter medications can cause blood glucose levels to increase even more. Complicating matters, your child's blood glucose levels may actually drop too low if he or she is vomiting or has stopped eating. You just can't be certain how an illness will affect your child's blood glucose—that's why it's important to check their levels more often than you normally would. A general guideline to shoot for is to check their blood glucose every 2 to 3 hours, but remember—that's a guideline. Your child may require more or fewer checks, depending on your health care professional's recommendations. In addition to checking blood glucose levels, you also need to check for the presence of ketones in the urine. In people with type 1 diabetes, common illnesses can lead to diabetic ketoacidosis, a condition characterized by acidic blood caused by the release of too many ketones. Ketones are released when your body doesn't have enough insulin, so it's important to check your child's urine regularly (usually every 4 hours) until there are no ketones detected. If ketones are still present, that's a sign that your child needs more insulin. There are 2 ways to check ketones: using urine ketone strips Continue reading >>

Checking Urine Glucose And Ketones

Checking Urine Glucose And Ketones

Checking urine for ketones Urinary ketones are checked by dipping a chemically treated strip in a fresh sample of urine. The colour change is then compared to a chart. A purple colour means ketones are in the urine. Ketones are a sign that too much fat has broken down in the body. There may be a number of causes, such as too little insulin or the stress of an illness. Ketones are a cause for concern if they are present when the blood glucose is high (greater than 14 mmol/L or 250 mg/dL). Check urine ketones whenever: the blood sugar level is over 14 mmol/L (250 mg/dL) for 3 readings in a row your child is feeling ill, has a fever, or has vomited your child has symptoms of high blood sugar, such as increased thirst and urination the diabetes team asks you to check for ketones, perhaps when the insulin dose is being adjusted Have strips at home for ketone checking at all times. Make sure that the strips have not expired by checking the expiration date on the bottle. The bottle should be kept closed. Once the bottle is open, the strips must be used within 6 months. Note that strips are available to check for glucose as well as ketones in the urine. Follow the instructions on the package carefully, and ask your health care team for help if the instructions are not clear. Checking urine for sugar Sugar in the urine is usually checked only as a back-up to checking blood sugar, or to screen other family members. A chemically treated strip is dipped briefly into a fresh urine sample. The strip will change colour. After a certain period of time the strip will be compared with a colour chart on the box. A urine check showing no sugar means that when the urine was made the blood sugar level was below the renal (kidney) threshold (about 8.0 to 12.0 mmol/L, or 145 to 220 mg/dL). A u Continue reading >>

Diabetes Urine Tests

Diabetes Urine Tests

Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Urine Ketones - Meanings And False Positives

Urine Ketones - Meanings And False Positives

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>

Ask The Diabetes Team

Ask The Diabetes Team

Question: From Houston, Texas, USA: Are moderately high ketones ever caused by anything else besides diabetes? I have IDDM but there's no prior family history. I found out that my 4 year old son had moderately high ketones in his urine the morning after the day I took him to the pediatrician for an asthma problem. I have a good pediatrician and I want to prepare myself for what he might say. My son has been sick for six months with asthma difficulties that get better only on steroids (liquids) but the wheezing and dry coughing comes back when the steroids wear off. He's never been this sickly. He has gained no weight and seems much skinnier to me, but last time I mentioned this to the doctor he said wait until he's well and we'll weigh him again. I'm thinking of asking for a glucose tolerance test. My son is terrified of needles and I don't want to push the unnecessary. Answer: Ketones are produced when the body breaks down too much stored fat to get extra fuel for energy. In fact, in normal metabolic conditions, the main energy source of our human machinery are carbohydrates (i.e., glucose). Quite often very young children with normal (or low) blood sugar are unable to get enough sugar from their stored fat and from stored sugar (glycogen) in the liver while they're are sleeping during the night or are in a "starvation" situation or not taking in normal calories and fluids: then most of the time they can have ketones in their urine in the morning. Stress and illnesses like asthma, flu, and infections, put a stress on the body of a child and this can make his body produce ketones. This usually occurs because in these conditions the body makes hormones like epinephrine and cortisol which cause the body to break down its own fat deposits; this would explain why your son h Continue reading >>

Ketones Urine Test

Ketones Urine Test

Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. Continue reading >>

Value Of Point-of-care Ketones In Assessing Dehydration And Acidosis In Children With Gastroenteritis.

Value Of Point-of-care Ketones In Assessing Dehydration And Acidosis In Children With Gastroenteritis.

Abstract OBJECTIVES: Children with gastroenteritis often develop dehydration with metabolic acidosis. Serum ketones are frequently elevated in this population. The goal was to determine the relationship between initial serum ketone concentration and both the degree of dehydration and the magnitude of acidosis. METHODS: This was a secondary analysis of a prospective trial of crystalloid administration for rapid rehydration. Children 6 months to 6 years of age with gastroenteritis and dehydration were enrolled. A point-of-care serum ketone (beta-hydroxybutyrate) concentration was obtained at the time of study enrollment. The relationship between initial serum ketone concentration and a prospectively assigned and previously validated clinical dehydration score, and serum bicarbonate concentration, was analyzed. RESULTS: A total of 188 patients were enrolled. The median serum ketone concentration was elevated at 3.1 mmol/L (interquartile range [IQR] = 1.2 to 4.6 mmol/L), and the median dehydration score was consistent with moderate dehydration. A significant positive relationship was found between serum ketone concentration and the clinical dehydration score (Spearman's rho = 0.22, p = 0.003). Patients with moderate dehydration had a higher median serum ketone concentration than those with mild dehydration (3.6 mmol/L vs. 1.4 mmol/L, p = 0.007). Additionally, the serum ketone concentration was inversely correlated with serum bicarbonate concentration (ρ = -0.26, p < 0.001). CONCLUSIONS: Children with gastroenteritis and dehydration have elevated serum ketone concentrations that correlate with both degree of dehydration and magnitude of metabolic acidosis. Point-of-care serum ketone measurement may be a useful tool to inform management decisions at the point of triage or in Continue reading >>

Ketones — Urine

Ketones — Urine

Definition Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. A urine test can be done to check the level of ketones in your body. Alternative Names Ketone bodies - urine; Urine ketones How the test is performed The test requires a clean catch urine sample. To obtain a clean catch sample, men or boys should clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl to clear the urethra of contaminants. Then, put a clean container under your urine stream and catch 1 to 2 ounces of urine. Remove the container from the urine stream. Cap and mark the container and give it to the health care provider or assistant. For infants, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia. Diaper as usual over the secured bag. This procedure may take a couple of attempts -- lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory. Urine ketones are usually measured as a "spot test" using a dipstick coated with chemicals that react with ketone bodies. The dipstick is dipped in the urine sample, and a color change indicates the presence of ketones. How to prepare for the test You may have to eat a special diet, and you should stop taking a Continue reading >>

Children With Diabetes: Is It Safe To Play Sports?

Children With Diabetes: Is It Safe To Play Sports?

With a few safety checks in place - blood sugar tests, a snack, and breaks - exercise for kids with diabetes is not only safe, it's recommended by the American Diabetes Association. Exercise can lead to better blood sugar control and fewer complications in the long run. It can also help with weight management and stamina. But there are some very important things you need to know first. Watch out for high or low blood sugar emergencies Children with diabetes need to be extra careful when they exercise. They should always test their blood sugar levels before they start their physical activity. They should not exercise if the blood sugar is too low or too high. Your child's doctor can tell you the range of blood sugar levels for safe exercise. The more active your child is, the lower his or her blood glucose levels may drop. Blood glucose levels may stay low for hours after exercising. If blood glucose levels drop too low, your child can have a low blood sugar reaction (hypoglycemia). Symptoms of hypoglycemia may include: Feeling shaky Weakness Dizziness Irritability If your child has any of these symptoms while exercising, he or she should stop right away and take some glucose. Also, your child should not exercise when blood glucose levels are too high (hyperglycemia). Hyperglycemia is a sign of not having enough insulin in your body. When your child does not have enough insulin, the body breaks down fat to make up for the missing insulin. This process produces a dangerous compound called ketones. When ketones build up in the blood, your child can become very sick. The body tries to get rid of the ketones by flushing them out in the urine. You can test your child's urine for these ketones. How can I help my child prevent a low or high blood sugar emergency? Children with Continue reading >>

Diabetic Ketoacidosis In Children

Diabetic Ketoacidosis In Children

GENERAL INFORMATION: What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your child's blood sugar levels become high because his body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces his body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in the blood. Ketones are dangerous at high levels. What increases my child's risk for DKA? Not enough insulin Poorly controlled diabetes Infection or other illness Heart attack, stroke, trauma, or surgery Emotional stress Being female What are the signs and symptoms of DKA? Your child may feel very thirsty, and urinate more than usual. He may have a fever. He may also have any of the following: Dry mouth, eyes, and skin Fast, deep breathing Faster heartbeat than normal for him Abdominal pain, nausea, and vomiting Fruity, sweet breath Mood changes and irritability Feeling very weak, tired, and confused Weight loss How is DKA diagnosed? Your child's healthcare provider will ask about your child's symptoms and how his diabetes is managed. He will look for signs of dehydration and check your child's height and weight. Your child's blood and urine may be tested to check his blood sugar and ketone levels. These and other tests will show if your child is dehydrated. He may also need an EKG to check his heart rhythm. Your child may need more tests to find out what triggered his DKA. How is DKA treated? DKA can be life-threatening. Your child must get immediate medical attention. The goal of treatment is to replace lost body fluids, and to bring blood sugar levels back to normal. Your child may need any of the fol Continue reading >>

Kids And Ketones: Checking And Treating High Blood Glucose

Kids And Ketones: Checking And Treating High Blood Glucose

Low blood glucose levels usually have warning signs such as shaking, sweating and rapid heartbeat, but high blood glucose levels can be silent until things start to get out of control. The staff in the Joslin Pediatic Clinic has this advice. One of the vital warning signs of an impending diabetic crisis is the appearance of ketones in the blood or urine. For children with type 1 diabetes and their parents, understanding the role of ketones in a diabetic emergency and knowing how to check for them and what to do if your child has them can mean the difference between a good night’s sleep and many tense hours in the emergency room. (Ketoacidosis almost always occurs in people with type 1 diabetes) Too little insulin for too long a time initiates a cascade of hormonal changes in the body that can lead to the dangerous condition of diabetic ketoacidosis (DKA). If left untreated, it can lead to coma and death. In the face of inadequate circulating insulin, glucose builds up in the blood instead of moving into the tissue cells where it would be used for fuel. Without glucose to burn for energy, the body turns to fat for fuel. The special type of fat it uses is called ketones. Because ketones are an acid, the body needs to supply a base (the opposite of an acid) to neutralize their effects and maintain the blood’s natural pH. However, the body’s supply of base,such as NH3 (anydrous ammonia) (is limited and at some point the system is overwhelmed and the blood pH starts to decline. This drop in blood pH is one of reasons ketoacidosis is so serious. The body can’t accommodate changes in blood pH well. Illness can often be a precipitating cause of DKA. Infection can spike glucose levels and additional insulin is often required. If the needs for additional insulin aren’t Continue reading >>

Dehydration In Children - Treatment

Dehydration In Children - Treatment

A A A Dehydration in Children (cont.) Be concerned if your child has an excessive loss of fluid by vomiting or diarrhea, or if the child refuses to eat or drink. Signs of dehydration include: Sunken eyes Decreased frequency of urination or dry diapers Sunken soft spot on the front of the head in babies (called the fontanel) No tears when the child cries Dry or sticky mucous membranes (the lining of the mouth or tongue) Lethargy (less than normal activity) Irritability (more crying, fussiness with inconsolability) Infants and small children can become dehydrated quickly. Contact your doctor if your child has any of the following: Crying without tears No urine output for over a period of four to six hours Sunken eyes Blood in the stool Vomiting for more than 24 hours, or vomiting that is consistently green in color Fever higher than 103 F (39.4 C) Less activity than usual Urination much more than usual If your child is lethargic (difficult to awaken) If you cannot reach your doctor If your child's mouth looks dry The doctor will perform a thorough history and physical exam in an effort to determine the severity and cause of the dehydration. Specific laboratory tests may be ordered. A complete blood count may identify an infection. Blood cultures may identify the specific kind of infection. Blood chemistries may identify electrolyte abnormalities caused by vomiting and diarrhea Urinalysis may identify bladder infection, may give evidence of the severity of dehydration, and may identify sugar and ketones in urine (evidence of uncontrolled diabetes). In some cases, the doctor may order other tests, such as a chest X-ray, a test to check for rotavirus, stool cultures, or lumbar puncture (a spinal tap). Continue Reading A A A Dehydration in Children (cont.) Dehydration in chil Continue reading >>

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